Alternative to Mental Hospital Treatment

Cost-Effectiveness of Crisis Resolution Home Treatment for Managing Acute Psychiatric Crises in Southern Switzerland

“…Our study showed that CRHT was less expensive than hospitalization both during the treatment and the follow-up periods, even if the difference was not always statistically significant. This result is perfectly in line with several previous findings [ 12 , 14 , 32 – 34 , 38 , 43 , 44 ] and partially in line with some others reporting lower CRHT total costs but higher outpatient costs [ 13 ] and lower or higher CRHT costs depending on the medical site considered [ 37 ], but is in contrast with two other studies reporting higher CRHT costs [ 35 , 36 ]. CRHT resulted cost-effective in comparison with hospitalization for the follow-up phase, but cost-effectiveness for the treatment phase depended on the types of psychiatric symptoms considered and on the theoretical value that society attributes to a one-unit increase in effectiveness (CRHT cost-effectiveness lowered as the value increased).…”

“…CRHT resulted cost-effective in comparison with hospitalization for the follow-up phase, but cost-effectiveness for the treatment phase depended on the types of psychiatric symptoms considered and on the theoretical value that society attributes to a one-unit increase in effectiveness (CRHT cost-effectiveness lowered as the value increased). The findings regarding the follow-up period are in line with many others reporting general cost-effectiveness of CRHT [ 12 , 32 , 34 , 36 – 38 ], while the findings concerning the treatment phase are similar to others indicating that cost-effectiveness of CRHT may vary according to the value that society attributes to a one-unit increase in effectiveness [ 13 , 14 ] and to the combination of CRHT and inpatient treatment received [ 39 ]. The heterogeneity of the empirical evidence presented makes it difficult to draw robust conclusions on CRHT cost-effectiveness in comparison with standard inpatient treatment.…”

Costing mental health services

“…Thus, the simple comparisons of hospital and community welfare and costs for the group of leavers reveal that community care is noticeably less costly than hospital for this cohort, and at least as good as hospital in maintaining standards of client welfare. This result is thus in line with the North East Thames study findings (see section 5 above), and consistent with the US results of, inter alia, Weisbrod et al (1980), Cassel et al (1972, and Murphy & Datel (1976), although these are concerned with different policy contexts. It was also found, not surprisingly, that the most dependent clients received packages of services which were more costly than hospital, again consistent with our NETRHA findings (see Table 5 for evidence) and with Hafner & an der Heiden (1989).…”

Cost-effectiveness of assertive community treatment teams.

“…It was in this context that the present study was conducted. Its results support those of Weisbrod, Test, and Stein (1980), showing the ACT intervention to be an effective alternative to hospitalization. Clients assigned to ACT teams accrued significantly more time in the community than did those served by mobile individual case managers with access to a rich array of community services.…”